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Alia J Wantuch, PTA

Physical Therapy Assistant in Port Orange, FL. Individual provider (NPI-1).

NPI number1164026902
StatusActive
Last updated in NPPESNov 23, 2020

Details

NPI
1164026902
Entity type
Individual (NPI-1)
Name
Alia J Wantuch
Credential
PTA
Sex
Female
Sole proprietor
No
Enumeration date
Nov 23, 2020
Certification date
Nov 23, 2020
Last updated
Nov 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPTA30714FLYes

Practice location

4606 Clyde Morris Blvd Ste 1d
Port Orange, FL 32129-7453

Phone 386-492-2986

Mailing address

1820 Creekwater Blvd
Port Orange, FL 32128-4088

Phone 386-871-4431

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Other Physical Therapy Assistant providers in Port Orange, FL

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